Not Just an Issue for Teenagers

There is more awareness about self-harm nowadays than when I was a teenager – and rightly so. However, self-harm in adults is less visible and under-represented in the media. The stereotypical depiction of self-harm involves a teenage girl and there are few depictions of self-harm which demonstrate the diversity of people affected. People who don’t fit the stereotype, such as males and adults, can feel ignored, excluded and isolated.

 

The Problem with Self-Harm Statistics

Self-harming behaviours are often secretive, meaning they can continue unnoticed – even by close friends and family – for years. Statistics are reliant on people attending hospital emergency departments as a result of self-harm, or presenting themselves to their GP or another medical professional. It is known that the issue is under-reported, but nobody is sure to what extent.

I tried to research self-harm statistics for this blog post and discovered that they focus overwhelmingly on children and teenagers. The most comprehensive and accessible information I could find was a NICE guideline document: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. It raises a lot of concerns in how self-harm is addressed, including incidents of people being “told off” by doctors and nurses.

This suggests a key reason for adults, in particular, under-reporting self-harm: fear of being judged. If medical professionals have such patronising and ignorant attitudes, how can we expect the general public to be empathetic?

 

Issues for Adults who Self-Harm

Self-harm is one of the most stigmatised mental health issues because people who have never experienced it struggle to understand. It seems illogical: it is a coping mechanism which causes physical injury. Because self-harm is misunderstood, it’s difficult for sufferers to confide in others. Many people react with shock and unhelpful comments like “don’t do it” and “what do you want to do that for?” This can leave the person experiencing self-harm feeling worse.

To change this situation, the first step is education. There are many grassroots organisations doing great work to raise awareness of self-harm and other mental health problems, including The Project, where I volunteer. I recommend attending a mental health workshop or training course so that you can discuss the issues involved as you learn. However, a good starting point to learn the basic facts about self-harm, and how to access help and support, is the Mind website.

Unfortunately, the portrayal of self-harm as something which only affects teenagers and young people has led to sufferers thinking they should have “grown out of it.” This makes it harder to discuss self-harm, even with people you trust, and prevents people from accessing treatment and support services.

LifeSIGNS, a charity whose aim is to create understanding about self-injury, has an interesting article on the issues which affect adults who self-harm. The comments underneath are particularly effective at helping adults who self-harm to realise they are not alone. The article refers to shame and secrecy (but is a little dismissive, in my opinion), which is a massive issue – especially as self-harm in adults is rarely addressed by the media and support services are often aimed at teenagers and young people.

 

My Experience of Self-Harm as an Adult

I last self-harmed at the beginning of May, about three and a half months ago. I don’t think I have mentioned it on this blog, because although I am pretty open about my mental health, I still find it difficult to talk about self-harm. In particular, I find it difficult to discuss recent self-harm.

I’m a lot more open than I used to be. For years, I worse long sleeves in heat waves and never exposed my scars to anyone outside of my immediate family. I have come to view my scars not as sources of shame, but as symbols of strength. I have experienced mental health problems and self-harmed for two decades, yet I’m still here. I have managed to do things I thought were out of my reach, despite struggling all the way.

If anyone asks me about my scars nowadays (which is very rare, I think because people recognise them as self-harm scars whereas there was less awareness when I was a teenager), I tell the truth. I cringe when I remember the excuses I used to make: when a friend asked about scratches on my arms when we were changing for PE, I said I fell into some brambles when picking blackberries! I don’t think she believed me, since all of the scratches went in the same direction… But now, I don’t feel the need to hide my history of self-harm.

Yet my attitude towards recent self-harm is different. I feel more ashamed of recent scars and wear long sleeves when the wounds are still fresh. I hate talking about specific incidents. I avoid mentioning it at all.

I think this attitude rests on two facts about my current situation:

1. I self-harm far less frequently than I did from the age of 13/14 to 22. There have been periods of several months and more (I think over a year at one point) when I didn’t self-harm. While this is progress and symptomatic of my coping better, I feel worse when I do self-harm because it feels like failure.

2. I’m older. I can logically acknowledge that self-harm affects people of all ages and would never judge other adults who self-harm, but I feel I should have stopped by now. It should be something I used to do as a teenager but have left behind as I matured. Like drinking Bacardi Breezers.

I want to be more open about self-harm (recent and historic), but it’s difficult to discuss in our current society. People seem to understand anxiety and depression far better than self-harm. Perhaps this is because the emotions and behaviours associated with anxiety and depression are better known and commonly experienced. For example, while most people do not experience anxiety to a debilitating degree, they do know what it feels like to be anxious and can extrapolate from this experience to empathise with people who experience anxiety disorders. Fewer people have experienced the compulsion to harm themselves in order to ease emotional distress.

The trouble is, there is a circularity inherent in this issue: in order to create a more understanding and compassionate society, more people need to speak out about self-harm and other mental health issues. However, until society is more understanding and compassionate, this involves risks and is therefore a daunting prospect.

 

The Curse of Speaking Out about Self-Harm

One of the most prevalent myths about self-harm is that people do it for attention. Most people who have experienced self-harm – or know someone who has experienced it – can recognise that it’s ridiculous. The majority of sufferers go to great lengths to hide self-harm and some put their lives at risk, refusing to seek treatment because they are ashamed and afraid of being judged. However, some people believe the myth – which means as soon as people begin to speak out about self-harm, they are accused of seeking attention.

Leaving aside the question of whether one person’s “attention seeking” is another’s cry for help, self-harm is an issue which needs attention. On both an individual and an abstract level. People who self-harm are more likely to attempt and complete suicide than the general population. Self-harm also involves a lot of emotional distress and silencing people who self-harm exacerbates their pain.

I wrote this post not because I want sympathy or attention for myself, but because I don’t want other adults who self-harm to feel alienated. Some teenagers who self-harm may stop when they become adults – but some of us can’t. Others begin self-harming as adults. Nobody deserves to feel ostracised and unsupported because they self-harm. Nobody deserves to be “told off” by medical staff because they suffer from a mental health issue.

So yes, please give attention to everyone who self-harms – including adults. Attention in the form of accessible treatments and support, compassion, empathy, accurate media depictions and increased awareness of self-harm.

Acknowledging Difference and Mental Health

It’s great that mental health issues are getting a lot of publicity at the moment, thanks to the Heads Together campaign and its royal endorsement. It’s also wonderful to hear Prince Harry talking openly about his mental health problems following his mother’s death. All of this is positive and deserves to be celebrated. However, we also need to hear the stories about people who struggle with mental illness and aren’t famous. Stories told by people whose mental health prevents them from going outside, let alone running a marathon.

It’s ironic that the right-wing, tabloid media praises some people for sharing their experiences of mental illness while, at the same time, castigating people with mental illness who claim benefits. If poor mental health prevents you from getting work, you can expect to be scrutinised – by the general public, as well as the media. When you go to a pub for the first time in several months, some people view it as proof that you are a scrounger who is playing the system; as though you choose to resign yourself to the poverty and humiliation of surviving on benefits, rather than getting a job which would give you some money and dignity. There is still a lot of ignorance surrounding mental health and we need to pay attention to the full spectrum of experiences.

Part of the problem is the reporting bias in mental health.

Some stories about mental health are more clickworthy than others. People like to read about a celebrity who goes off the rails, but they aren’t interested in ordinary people who spend their days lost in a fog of depression. There’s less spectacle involved. It’s bloody boring. Spectacle is also a factor in how different mental illnesses are represented – often in stereotypical, unrealistic ways. Soap characters with mental illness, for instance, tend to have public meltdowns and melodramatic plotlines. The majority of people with mental health problems don’t get sectioned or use violence against other people, but I guess showing reality is too banal: it involves a lot of sitting around as your thoughts play out an invisible battle royale.

The media also like stories of people overcoming their mental illness, but for some of us, recovery seems unlikely and active management is a more pertinent goal. In my own experience, for example, mental illness is chronic and fluctuates: bad episodes are punctuated by good episodes. My goal is to change the balance, so that good episodes are punctuated by bad episodes. Again, it’s wonderful to hear stories from people who have completely recovered from mental illness, but we also need stories from people who might never recover. I suppose that’s one of the aims of my blog – to show what life is like when you’re negotiating it with long-term mental health problems.

Perhaps the most significant aspect of the reporting bias is that mental illness makes you think nobody wants to hear your story.

Depression and anxiety, in particular, generate a plethora of negative thoughts which convince you that you are worthless, useless, subhuman. You can’t ignore these thoughts, so you start to believe them and eventually, they seem to be part of you, an undeniable truth. Given this, it’s not surprising that many of us struggle to confide in friends and family, let alone broadcast our experiences to the world. Nobody should be ashamed to have mental health problems, but when they have a stranglehold on you, it’s almost inevitable that you feel shame.

There are also a lot of issues with political correctness which affect how stories about mental health are told – and whether they are told at all. For example, I once submitted a blog post to a mental health campaign about how when I was diagnosed with borderline personality disorder, I felt relief because it explained my symptoms. After asking me to rewrite the post several times, with little guidance on what she was looking for, the person who contacted me said it wasn’t the kind of story they wanted to use, because other people don’t have the same experience. In my view, that’s exactly why such stories should be published – because there is no single experience of mental illness and assumptions need to be challenged.

If we are afraid to express ourselves – or to give platforms to others so they can express themselves – in case a differing viewpoint or experience causes offence, or challenges common perceptions, then the campaigns for mental health are doomed to be ineffective. We need to hear about a range of experiences. We need to hear provocative stories. Otherwise the debate is stymied before it has even gathered pace.

We need to stop censoring and invalidating our experiences of mental health problems.

Another facet of the reporting bias, especially self-reporting, is fear. People are afraid to talk freely and honestly about their mental health experiences. A lot of this fear is fear of being judged and discriminated against, which creates a vicious circle because discrimination won’t end unless we can discuss mental health issues without fear of being judged.

I was afraid to talk about my mental illness when I was younger, especially when I was employed. I thought people would view it as a weakness and use it as ammunition. Unfortunately, some people did. But when I started talking more, something amazing happened: other people told me they had similar experiences. I felt less isolated and more supported.

Since I have been blogging, some people have commented that I’m courageous for speaking out. I usually dismiss these comments, since I feel I don’t have anything to lose – I’m self-employed now and have reached the stage where I’m sick of being ashamed of my mental illness, so will tell anyone willing to listen. However, I have been considering the possibility that these people are right and it does take courage to speak out in any way you can. Perhaps by dismissing such compliments, I’m negating both my own courage and the courage of others who blog, vlog, talk and write about their mental health.

So yes, speaking out takes courage, but I believe the alternative is worse: a world in which people with mental illness are afraid to discuss the issues they face. A world where people experiencing mental health problems feel alone and unworthy of help and support.

Through sharing a wider range of stories about mental health, we move further away from that world.

Some people still inhabit the world I mentioned, where they consider their mental health problems taboo. When they see and hear stories about experiences of mental illness which are vastly different from their own, they feel more isolated. The majority of mental health stories in mainstream media feature people who have access to resources which others are denied: money, strong support networks, advocates. While these resources can’t counterbalance the pain of mental illness, they do make it easier to cope.

A lot of people are ignorant of the issues surrounding access to resources, because it’s rarely brought to their attention. I’m guilty of taking some of my own resources for granted, such as the security of living with my parents and the practical support they give me. I’m also guilty of being jealous of resources other people have which I have never had, such as a partner and money for private therapy. Even something as simple as transport is a major issue concerning mental health: learning to drive made a huge difference to my life, because it gave me access to treatments and I could visit my friends more. My anxiety prevents me from using public transport more than it prevents me from driving, so I would not have managed my mental health so well without being able to drive.

These issues need to be addressed more in mainstream media, so that we can provide more opportunities and access to a greater range of resources for people with mental health problems. We need to hear more stories from people with limited resources, so that others in similar situations don’t feel ignored.

Raising awareness of these issues will also prevent people from making well-meaning, or ignorant, but hurtful comments to people with mental illness. For example, people’s reactions when they learn I live with my parents: they joke about me being too old and too comfortable with the perks. The reality is, I can’t afford to move out because I have relied on benefits for years and when I have been in work, the jobs paid low wages and/or were part time. I also doubt I could cope with living alone, as much as I desire it, especially during bad episodes.

When I was on antidepressants, I relied on my mum to get my prescription for me. Without her, I wouldn’t have been able to access medication. She also makes sure I eat when I’m depressed and hides the painkillers when I feel suicidal. Frankly, I dread to think what state I’d be in if I lived independently. I didn’t choose to have mental health problems, so it’s a bit difficult to nod along when someone tells me I could live in a flat share or to laugh when someone suggests the real reason I haven’t moved out is because I “have it too good.” If situations like mine were represented in the media more often, perhaps I wouldn’t be patronised or forced to explain myself when someone thinks they have the right to know why a woman in her 30s lives with her parents.

Raising awareness of issues surrounding mental health and humanising them through sharing individuals’ experiences would promote compassion and empathy.

A massive problem with reports on benefits is that they are either faceless or portray stereotypes. When benefits cuts are announced, news stories are illustrated with people who appear mentally and physically healthy, usually with multiple kids, who talk confidently and are coerced into making a comment which implies they are scroungers with no intention of supporting themselves. The bias is shocking, but not as shocking as the fact that many people don’t recognise it as bias.

A large proportion of the public believes what they are told by The Sun and The Daily Mail. They don’t realise that some people exist who don’t fit these stereotypes – people who battle against their mental illness and still can’t function, people who would love to work but can’t find a job offering the flexibility needed to work around fluctuations in their mental health, people who claim benefits not because it’s easier than working (hah!) but because they have no other choice. Acknowledging their existence could make a huge difference in itself. We need to tell these people’s stories.

People might acknowledge that mental illness affects people from all walks of life, but they don’t consider what this means. It means that people from poor backgrounds struggle to get adequate treatment via the NHS. It means that when someone’s benefits are stopped without warning, because someone unqualified in mental health has looked at a form and decided their illness doesn’t count as a disability, they can’t afford to eat or pay rent. It means that mental health problems can cause other problems, such as unemployment and isolation, creating a downward spiral which feels impossible to escape.

Perhaps if we told everyone about these experiences, as well as the more positive ones, people with mental health problems would be treated better – by both the government and the general public. There would be greater understanding and more kindness.

I want rich and successful people to tell their mental health stories, but I don’t want them to overshadow what the majority experience.

I want to show that mental illness need not prevent you from achieving your goals, but I also want to tell you that it’s okay if it does – it’s not your fault. Unfortunately, the effect of publicising stories from people who are either born into privilege or have achieved privilege through their career is that other experiences are excluded. This exclusion gives space for incorrect assumptions to arise: that if money doesn’t prevent mental illness, then poverty isn’t an issue which affects mental health and people who say their mental illness stops them from accomplishing goals are just making excuses. We need to address these assumptions by showing that they are untrue.

We need to make the invisible stories more visible. We need to acknowledge that while people with mental health problems can achieve great things, like running marathons and building incredibly successful careers, sometimes getting out of bed or taking a shower are huge achievements. We have started the conversation – now let’s broaden it and explore everyone’s experiences.

Chatting vs Counselling

Chatting and counselling are not the same.

I’m sick of the number of times I have heard people say things like this:

“Counselling won’t do any good — it’s just talking.”

“Talking about stuff doesn’t help, so counselling is a waste of time.”

“If I wanted to talk about my problems, I’d talk to a friend — there’s no waiting list and it’s free.”

These comments stem from supreme ignorance regarding counselling. I believe most of the people who say these types of remarks have never tried counselling. Their perceptions are based on snippets of (often mis)information they have gleaned from television, social media and the tabloid press.

I’ll repeat it in the hope that the words sink in: chatting and counselling are NOT the same.

If you have never experienced counselling and would like some background information, check out this brief overview from the NHS.

 

Counselling provides you with a safe environment.

One of the main benefits of counselling is that it provides a safe space for you to express your feelings. You can talk without interruptions. You can say anything without fear of being overheard. It’s confidential and you won’t be judged.

Clarification: you might feel as though you will be judged, but that doesn’t make it true. There is a possibility you will be judged by your counsellor, since humans have a tendency to make automatic judgments, but a professional will never expose you to this judgment because they understand that it’s their issue, not yours.

This isn’t true of the people in your life, no matter how empathetic and compassionate they are, because they cannot separate themselves from their emotional relationship with you.

They also bring a lot of emotional baggage to the conversation — knowledge of your history, assumptions they have made about you based on your interactions, their own desires (to be liked by you, to avoid conflict, to steer you onto a path which suits them). All of these things influence the conversation in ways which, while well-meaning, can be unhelpful.

 

Because you have no emotional connection to your counsellor, you can talk about yourself, your relationships and your problems in a different way.

You don’t need to censor yourself. You don’t have to worry about hurting the other person’s feelings. You don’t need to consider the other person’s life and whether what you say might be insensitive given their circumstances.

You can focus on yourself 100%

Maybe that sounds unimportant, but unless you are a narcissist it’s likely that you seldom have the opportunity to talk about your situation without considering anyone else. When you chat with a friend, you not only consider their feelings, but also the information you are revealing about people they know — your partner, children, parents, siblings, other friends, etc.

When you talk to a friend, you censor what you share. You do it to spare their feelings and also to show yourself in a certain light, to avoid jeopardising your relationship. This means you are presenting a skewed, inaccurate picture of your problems.

Doing this isn’t a bad thing — you are protecting yourself, the person with whom you are talking and other friends/family members — but it isn’t the most conducive way for you to find solutions to your problems. Especially if you have complex mental health problems.

Counselling enables you to set out your problems with as much clarity and accuracy as you can, free of the emotional politics which are present in any relationship.

The counsellor will ask questions which allow you to see your situation from a different perspective. He or she will explore the issues you bring to the table and help you choose what to do. Often, he or she will play devil’s advocate and encourage you to answer the questions you have been too afraid to ask, such as whether talking a certain course of action would be truly disastrous or if there would be a period of discomfort followed by greater happiness in the long term.

Compare this to a chat with friends who, even with the best intentions, will say things like “you can’t leave your husband because he loves you” or “you shouldn’t quit your well-paid job because you don’t know if you’ll need the money in future.” These comments are usually based on their own fears and ideas about “conventional behaviour.” They are unhelpful and potentially damaging, no matter how well-meaning the spirit in which they are said.

The result is whereas chatting with a friend can be reassuring, it will not allow you to fully consider your options in the same way that counselling can.

 

Counsellors are trained to deal with mental health problems.

Your friends are not. I’m pointing out the obvious because it’s important: a counsellor will recognise when what you are saying is indicative that you intend to harm yourself or another person. They won’t shut you off when you discuss feeling suicidal, convinced that it means you are about to kill yourself today. Neither will they ignore the warnings which untrained people might not recognise.

Mental health professionals have protocols in place which enable them to handle dangerous situations. When you attend your first counselling appointment, the counsellor tells you that everything you say is confidential but if they think you are in danger of harming yourself or another person, they have a duty to intervene. If this happens, they will follow the appropriate protocol.

In contrast, your friends probably wouldn’t know what to do if they believed you were about to harm yourself or someone else. They might take a course of action which puts you, themselves or other people at risk through their ignorance. 

This applies to their comments as much as contacting authorities. Many people make well-meaning comments which could cause distress and cause further damage to your mental health. Because your friends haven’t been trained in counselling, they are liable to make these comments when you are at your most vulnerable.

They will also find it difficult to hear you say certain things. It is horrifying to hear your friend talk about feeling suicidal, for example, even if they emphasise that they are not about to act on those feelings. Your friends’ instinct when they hear you say things which make them feel uncomfortable is to protect themselves by silencing you. This leaves you feeling, at best, unheard and frustrated.

It could also have more harmful effects, such as making you think you have no right to feel this way or that you are selfish/stupid/a terrible person — none of which is true. A counsellor, on the other hand, will listen. You can voice your deepest, darkest thoughts and emotions. They will empathise and empower you to explore these feelings.

Counselling is a safe way of expressing yourself: you won’t be silenced or exposed to comments which make you feel worse.

 

There are different types of counselling.

When you hear people talking about counselling, they usually give the impression that there is one definitive type of counselling. There is not.

There are many types of talking therapy and different counsellors use different approaches. Furthermore, counsellors with similar approaches may have different styles. For example, some might be more blunt and direct, whereas others focus on presenting themselves as compassionate and supportive. There is no “right” way and it may take some time and experimentation to find an approach and an individual counsellor who suits you.

Unfortunately, many people who try counselling don’t take this into account. They have a single bad experience and conclude that all counselling is crap and useless.

When they voice this opinion, it can lead people with no experience of counselling to think they are correct and have authority because they have tried counselling. This is dangerous. It prevents people from seeking help for their mental health problems.

Of course there are crap counsellors — there are people in all professions who somehow slip through the net despite their skills or manner of working not being up to the required standard. It shouldn’t happen, but it does. However, these people are a minority and should not be used as an example of the profession as a whole. If you encounter a counsellor who behaves unprofessionally, report them and find another counsellor — don’t write off counselling as an option because you have a bad experience.

You may also benefit from different types and styles of talking therapy at different times.

When I first had counselling, for instance, I saw a very nice lady who had been told by the NHS to deliver a CBT (Cognitive Behavioural Therapy) focused service because the efficacy of CBT has been proven in studies and appears to be more effective than counselling on its own. I diligently worked through the exercises and found that they didn’t help — I felt a little better during sessions, but this wore off soon after I got home. Looking back, I realise I needed a different type of talking therapy and even plain old counselling would have been better than CBT at the time. Later on, after receiving a year of drama therapy, I was ready to use those CBT techniques I’d learnt and nowadays I find them helpful.

The point is not to lambast counselling or any other therapy if it doesn’t work for you. It might work for other people. And don’t discount the possibility of it working for you in the future.

 

Talking with friends is great, but it’s not therapy.

I want to make it clear that I value talking to friends. I love chatting and do it a lot. At no point in this post have I meant to give the impression that talking has no value. In fact, I advocate talking about your mental health as much as you can — but in addition to seeking professional help.

It can be helpful to discuss your problems with friends, as long as you are aware that it cannot be a neutral exchange. When you have a relationship with someone, your conversations are loaded. It is a different type of dialogue.

I encourage you to chat about your mental health problems  to anyone you trust, but be aware that talking to friends and/or family is not an alternative to counselling.

Chatting can be a useful strategy in managing your mental health, but if you need more help don’t dismiss counselling as “just talking.” Don’t assume that it’s the same as hashing out your problems with your friends. And definitely don’t make ignorant comments about counselling when you haven’t given it a fair shot.

 

 

Response to Theresa May’s Announcement

On Monday, Theresa May announced that she intends to provide more support for children and young people with mental health problems. Here is a response I wrote on behalf of the mental health charity for which I volunteer:

The Project’s Response to Theresa May’s Pledge to Provide More Support  for Young People with Mental Health Problems 

While the blog is an official reaction from the charity, The Project, it also reflects my own views.

I have also come across a response from Mind which correlates with my thoughts:

Our Response to Theresa May’s Speech

The bottom line is it’s easy for politicians to make promises — and even easier for them to break those promises.

I’m glad that mental health issues are getting more attention in the media, but concerned that the average person will see/hear these reports and assume the government is addressing the problems effectively. This isn’t true in my experience, nor the experiences of various people I have met or heard about.

There are still massive problems at every stage, from raising awareness of mental health problems to providing treatment and practical support. These problems range from appropriate help being unavailable to people with mental health problems being patronised by the professionals who are supposed to support them.

There needs to be a complete overhaul in the way mental health is treated. Tackling a few peripheral aspects is not enough.

Don’t Label Me by Calling My Diagnosis a Label

When I scroll through the comments on Facebook posts about mental illness in general and borderline personality disorder in particular, there will invariably be at least one remark along the lines of “that’s a terrible label to have to live with.” Even if the subject of the post hasn’t expressed any concerns regarding their diagnosis, some random stranger claims that this diagnosis is a label.

In doing so, they are the ones labelling the person living with borderline personality disorder or other mental illnesses.

I have been diagnosed with borderline personality disorder and while I understand that some people feel their diagnosis is a label, I have never viewed my diagnosis as anything other than an acknowledgement that my symptoms fit the criteria for a specific medical condition. If you have been diagnosed with BPD (or any other mental illness) and regard it as a label, that’s your prerogative. However, you do not have the right to claim that my diagnosis is a label. Only I get to decide whether that is the case.

 

You might think you are helping by calling a mental illness diagnosis a label, but you are not.

If you insist on referring to a medical diagnosis as a label when there are people who have been diagnosed with the condition who don’t accept this interpretation, you are belittling their experience. It implies that you don’t believe they have a real illness and that their mental health problems are therefore their own fault.

Defining a mental illness as a label reinforces the divide in attitudes towards mental health and physical health. Few people would refer to a diagnosis of a physical illness as a label; it is just as ridiculous and insulting to refer to a mental illness as a label. By referring to mental illnesses as labels, you are perpetuating the stigma surrounding mental health.

 

When you call a diagnosis a label, it suggests that the illness is somehow invalid.

You may have your own complex, political reasons for thinking a certain diagnosis is a label, but most people who hear you refer to mental illnesses as labels will not be aware of them. They will interpret your opinion at face value and assume you mean that certain mental illnesses are not real. This is very damaging.

 

When people start to think of mental illnesses as labels, they overlook the suffering experienced by people who have mental illnesses.

With personality disorders in particular, they assume that people who have been diagnosed are merely eccentric or unconventional and are labelled as having a personality disorder in order to single them out. They think the diagnosis means that people with personality disorders are being told that their personality is flawed. This is not the case: diagnosis of personality disorders, like any medical diagnosis, is based on the presentation of specific symptoms.

These symptoms are frequently distressing and cause pain. They are not aspects of an eccentric personality. Referring to personality disorders as labels ignores the pain and distress caused by the symptoms.

 

Personality disorders are widely misunderstood – and referring to the diagnosis of a personality disorder as a label propagates this misunderstanding.

I am ashamed to say that I avoid mentioning my diagnosis of borderline personality disorder when I first meet people, though I talk openly about anxiety and depression. The reasons for my uncharacteristic taciturnity are that borderline personality disorder is difficult to explain in a few minutes and the name conjures up a lot of assumptions, misinformation and prejudice. Including the notion that it is a label rather than an actual medical condition.

I have had people make comments along the lines of “well, we all have different personalities” which demonstrate that they believe my mental illness is some type of personality definition, in much the same way as the results of the Briggs-Myers test (I’m an INFP, by the way). The name borderline personality disorder doesn’t help, but the lack of awareness is exacerbated by people referring to it as a label on social media.

 

Whether you consider your diagnosis a label is up to you – but mine is not.

What makes me angry is that I wouldn’t have to put up with this crap if borderline personality disorder was a physical illness. There may be a few crackpots who refer to diabetes and cancer as labels, but people pay less attention to them. The stigma surrounding mental health means that those who refer to mental illnesses as labels get an unjustified amount of attention; people are less likely to disregard them because thinking of mental illnesses as labels feeds into old prejudices about mental health.

Regardless of whether you intend to reinforce the myths that mental illnesses aren’t real and people should just get on with it, that is the effect you create when you refer to a mental health diagnosis as a label.

Of course, if you consider your mental health diagnosis a label, you have every right to voice your opinion. But that doesn’t mean everyone who has been diagnosed with the same condition considers it a label. When people tell me my mental illnesses are labels (which happens with anxiety and depression, though less often than with borderline personality disorder), it is disrespectful and potentially harmful.

Being told my illnesses are labels reminds me of myself pre-diagnosis, when I felt isolated and thought I was a freak; when I thought my illnesses were signs of some inner flaw. Diagnosis helped me move past that. You might feel labelled by your diagnosis, but I felt acknowledged. People were finally listening to me and I was reassured that I was suffering from mental health problems, rather than being some kind of mutant. It gave me hope that I could manage my mental health and perhaps recover. When you refer to my conditions as labels, you threaten that hope and reassurance.

 

Maybe diagnosis was a negative experience for you, but for many of us it is a positive step. By calling all diagnoses of a particular mental illness labelling, you negate our experience and silence us.

Don’t project your issues onto me or anyone else with mental health problems. Don’t assume that everyone’s experience is similar to yours and that everyone regards their diagnoses in the same way. Also be aware of the effects of referring to mental illnesses as labels: every time I read a comment like “that’s a terrible label to live with” I think “yes, because of people like you belittling my experience and perpetuating prejudice.”

Please don’t call my diagnosis a label – for me, it’s not.

 

 

 

Shocked By This Benefits News Story? I’m Not.

The fact that 90 people a month die after being found fit for work has shocked a lot of people. It should probably shock me, but after having to rely on benefits for nearly a decade, I’m not surprised. The Department of Work and Pensions (DWP) is determined to force people into work at any cost. They don’t care if vulnerable people suffer, as long as they meet their targets.

The government (who are supposedly elected to serve all citizens) insists that there is no proof of causation — and they are right, but lack of evidence is not the same as there being no link. If nothing else, the strong correlation between deaths and people’s Employment Support Allowance (ESA) being stopped is a cause for concern. The matter needs to be investigated.

The government seem to like picking on the poorest, most vulnerable people in society. As much as I abhor benefits cheats, they cost the country very little compared to the wealthy companies and individuals who avoid and evade paying tax. Punishing all benefits claimants in an attempt to weed out the cheats is an immoral and dangerous policy.

Unfortunately, people who work for the DWP are under so much pressure from their superiors and the government that they can’t afford to be compassionate. Very few of the employees I have dealt with understand mental illness. Some try to empathise, but they can’t get their head around the fact that someone with mental health issues can be “fine” one day and a wreck the next. They assume that recovery from mental illness is linear or simply a matter of time. They believe that if I had a job, I would be miraculously cured — despite my mental health being a key factor in my resigning every job I’ve had.

Even the people who have performed my medical assessments, to ascertain whether I’m still eligible for ESA, have not had qualifications related to mental health care. Yet, over the course of a 20-30 minute appointment, they are expected to determine the extent of my illness. And the Powers That Be would rather believe the results of these snapshot assessments than the testimony of my doctor and psychiatrist.

Two and a half years ago, I was taken off ESA. I won my appeal, but the two months of uncertainty and poverty were awful. My mental health declined further, after several months of progress. I became suicidal for the first time in three years. If I had not won my appeal, I’m sure I would have ended my life.

What other option would I have had? My parents can’t afford to support me indefinitely and my mental health is too poor to withstand working regular hours. The stress of having no money, in addition to my other problems, took its toll on my physical health as well. It reminded me of when I was struggling to hold onto my last job, being threatened with dismissal despite providing doctor’s notes stating that my illness was genuine and my absences necessary.

People on ESA and other benefits need to be empowered, not punished. We need enough money to be able to live, opportunities to develop our skills and support to guide — not force — us back into work. Until the DWP and the government stop caring more about targets than people, there will be more deaths.